Working with autistic individuals in prison-based interventions to address sexual offending Luke Paul Vinter A thesis submitted in partial fulfilment of the requirements of Nottingham Trent University for the degree of Doctor of Philosophy. December 2020. 1 Copyright Statement This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed in the owner(s) of the Intellectual Property Rights. 2 Acknowledgements Those who know me well know that I am not one to be particularly expressive or sentimental. However, in completing this thesis, I would feel remiss if I did not thank several people. First and foremost, I would like to thank all individuals from HMP Whatton and HMP Stafford (residents and staff alike) who took the time to participate in, advised on, and/or otherwise helped to facilitate my research. Without you all, this project would not have come to fruition. I would like to thank my supervision team- Dr Gayle Dillon, Prof Belinda Winder, and Dr Craig Harper. Gayle; without you, I would not be the same person that I am today. Beyond your guidance on this project, you helped me to build my conceptualisation of autism, taught me how to be strategic, provided me with invaluable career advice, and, most importantly, you have been an incredible role model for how to support others- thank you. Belinda; thank you for your honesty in your feedback (not being afraid to tell me how it is) and helping me to challenge and develop my views on the role of forensic psychology when working with individuals with sexual convictions. Lastly, Craig; thank you for your diligence in consistently providing clear, directive feedback. You struck a great balance between providing direction whilst supporting me to learn independently and develop my own critical viewpoint. I would also like to thank the countless teachers and lecturers, from primary school to university, who have each helped me to grow as an academic. Additionally, thank you to Rob and Jill from MaD Theatre Company. Without you, I would not have the confidence that has brought me this far and will benefit me for the rest of my career. I would like to thank my friends- “I don’t know half of you half as well as I should like; and I like less than half of you half as well as you deserve”. To my Macclesfield family- Richard, Leigh, Frida, Audrey, and the rest of Sunday club. Weekends spent out in nature, up in t’ hills, with good food, good drink and plenty of laughs were exactly what I needed to clear my mind, recharge and keep me going. Thank you to Peter. We started this PhD together, and our pub crawls and games nights were certainly some of the most memorable features of my PhD journey. To Alex, from undergrad to PhD, I’ve still not managed to shake you, but here we are; thank you for being the Legolas to my Gimli for the last decade. To Lindsay, thank you for your unwavering thoughtfulness and support. In my final year, when COVID-19 turned the world on its head, and pressure of the looming deadline built, you kept me focussed, healthy and have provided me with a sense of purpose. 3 Finally, I would like to thank my mum (Cheryl), dad (Paul), Nanna (Jean), and our pack of hounds back in Manchester. Collectively, you have instilled in me the competitive drive, work ethic, and no-nonsense northern stoicism that kept me motivated even in the most challenging periods of the PhD. You may have not always understood the ins and outs of the PhD and what it has involved, but nevertheless, throughout my life I have always been able to rely on you all for unquestioning support, in whatever form I have needed. A special thanks to my mum for helping me to collate and staple countless blank research materials, ready for distribution in the prisons. I hope that I have done each of you proud. 4 Abstract Research indicates that autistic individuals are no more likely to offend than anyone else in the general population. However, it has been suggested that when autistic individuals do offend, their offending behaviour can be contextualised by their autism. One of the most common forms of offending reported to be committed by autistic individuals are sexual offences, and research has outlined how autism can contribute to those offences. Additionally, recent research has also indicated that autistic prisoners may experience unique challenges and have specific support needs during their prison sentences, which potentially differ from their non-autistic peers. Despite this, little research has specifically explored how to work with, support and manage autistic individuals with sexual offence convictions (ISOCs) in prison-based interventions to address sexual offending. This thesis details an exploratory sequential mixed method approach used to explore effective work practices with autistic ISOCs in prison-based interventions to address sexual offending. Specifically, this thesis explored the following research questions; ‘How appropriate are current prison-based sexual offending interventions for autistic ISOCs?’ And ‘What is best practice when working with autistic ISOCs in prison-based sexual offending interventions?’. To answer these research questions, the thesis sought to: (i) identify challenges associated with prison-based sexual offending interventions for autistic ISOCs; (ii) identify beneficial features of prison-based sexual interventions for autistic ISOCs; and (iii) to generate evidence-based, practical recommendations on how to work with autistic ISOCs in prison-based sexual offending interventions. This thesis is constructed of six chapters. Chapter 1 provides a broad introduction to the topic background and rationale of the thesis, concluding with the overarching research questions and aims. Chapter 2 provides a discussion of the methodological issues that were relevant to the empirical studies of the thesis, including a rationale for the mixed method design. Chapter 3 reports Study 1, which was a qualitative narrative exploration of the life stories of autistic ISOCs (N= 4). This study incorporated an inclusive, participatory autism research approach, and discusses how diversity and similarities in those life stories may be relevant for interventions. Chapter 4 reports Study 2, a multi- perspective qualitative study that utilised a phenomenologically informed thematic analysis to explore the issues surrounding working with autistic ISOCS in prison-based interventions to address sexual offending, from the perspectives of autistic ISOCs (N= 12) and staff (N= 13). Chapter 5 details Study 3, a quantitative study that sought to confirm qualitative findings reported in Chapter 4; relating to the relationships between autistic traits, the prison social climate, mental wellbeing and readiness to 5 engage with interventions in a sample of ISOCs serving prison sentences (N= 177). Finally, Chapter 6 provides a synthesis and general discussion of the collective findings from the empirical studies. Chapter 6 also details practical recommendations for working with autistic ISOCs in prison-based sexual offending interventions, directions for future research, highlights the original contributions of the thesis, considers broader limitations of the research, and offers a final conclusion. 6 Table of Contents ACKNOWLEDGEMENTS ....................................................................................................................................3 ABSTRACT ........................................................................................................................................................5 TABLE OF CONTENTS ........................................................................................................................................7 LIST OF TABLES .............................................................................................................................................. 10 LIST OF FIGURES ............................................................................................................................................. 11 DISSEMINATION ACTIVITIES ASSOCIATED WITH THIS THESIS ......................................................................... 12 A NOTE ON TERMINOLOGY ............................................................................................................................ 14 CHAPTER 1: INTRODUCTION .......................................................................................................................... 17 1.1. AUTISM ........................................................................................................................................................ 17 1.1.1. Historical background ........................................................................................................................ 17 1.1.2. DSM criteria ....................................................................................................................................... 18 1.1.3. Sensory differences ............................................................................................................................ 21 1.1.4. Empathy and alexithymia .................................................................................................................